Some cardiovascular procedures include an intentional puncture of a wall in a cardiac chamber or blood vessel. For instance, the right atrial appendage is punctured in certain transcatheter procedures to allow a device to exit from within the right atrium into the pericardial space. Examples of such procedures include intra-pericardial heart valve annuloplasty and atrial appendage ligation. As another example, a hole can be created in the left ventricular apex during certain transthoracic mitral valve or aortic valve procedures. Other procedures can also result in a hole in the wall of a cardiac chamber or blood vessel, whether intentionally or accidentally.
If not closed quickly and safely, holes in the walls of cardiovascular structures can cause serious complications with high morbidity and mortality. One option is to surgically close such a hole. However, surgical closure techniques require access to the site of the hole, which may not be possible and/or can cause bystander injury to adjacent structures.